Provider Demographics
NPI:1174157309
Name:MORTON MEDICAL MANAGEMENT, PLLC
Entity type:Organization
Organization Name:MORTON MEDICAL MANAGEMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYSON
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-403-4868
Mailing Address - Street 1:7909 GARDENGATE LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-1071
Mailing Address - Country:US
Mailing Address - Phone:817-403-4868
Mailing Address - Fax:
Practice Address - Street 1:7909 GARDENGATE LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-1071
Practice Address - Country:US
Practice Address - Phone:817-403-4868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty